NURS 6660 Discussion: Pediatric Bipolar Depression Disorder Debate

NURS 6660 Discussion: Pediatric Bipolar Depression Disorder Debate

Week 8: Mood Disorders

“School and going out with my friends used to be fun, but not anymore. Mom keeps telling me just to go out and have fun, but I don’t see the point of trying. All my friends are better than I am. I keep having these headaches and just feel worthless. I used to get As and Bs in school, but not anymore. I can’t concentrate at school. I would rather be at home sleeping.”

Madison, age 16

Mood disorders can be particularly challenging to address in childhood and adolescence as many parents do not believe it is possible for their child to become depressed or even suicidal. The PMHNP needs to know how to diagnose these conditions and must understand the importance of integrating medication management strategies, with both individual and family therapy to optimize treatment outcomes.

This week, you debate the theory that bipolar depression can or cannot be diagnosed in children and adolescents.

Photo Credit: Corbis/VCG / Corbis / Getty Images


Learning Resources

Note: To access this week’s required library resources, please click on the link to the Course Readings List, found in the Course Materials section of your Syllabus.

Required Readings

Sadock, B. J., Sadock, V. A., & Ruiz, P. (2014). Kaplan & Sadock’s synopsis of psychiatry: Behavioral sciences/clinical psychiatry (11th ed.). Philadelphia, PA: Wolters Kluwer.

  • Chapter 31, “Child Psychiatry” (pp. 1226–1253)

American Psychiatric Association. (2013). Diagnostic and statistical manual of mental disorders (5th ed.). Washington, DC: Author.

  • “Bipolar and Related Disorders”
  • “Depressive Disorders”

Note: You will access this book from the Walden Library databases.

Zeanah, C. H., Chesher, T., & Boris, N. W. (2016). Practice parameter for the assessment and treatment of children and adolescents with reactive attachment disorder and disinhibited social engagement disorder. Journal of the American Academy of Child & Adolescent Psychiatry, 55(11), 990–103. Retrieved from http://www.jaacap.com/article/S0890-8567(16)31183-2/pdf

Stahl, S. M. (2014). Prescriber’s Guide: Stahl’s Essential Psychopharmacology (5th ed.). New York, NY: Cambridge University Press.

 

Note: All Stahl resources can be accessed through the Walden Library using the link. This link will take you to a login page for the Walden Library. Once you log in to the library, the Stahl website will appear.

 

To access information on the following medications, click on The Prescriber’s Guide, 5th Ed. tab on the Stahl Online website and select the appropriate medication.

Review the following medications:

Seasonal affective disorder

  • bupropion
Bipolar depression Bipolar disorder
amoxapine
aripiprazole
armodafinil
asenapine
bupropion
carbamazepine
fluoxetine
iloperidone
lamotrigine
lithium
lurasidone
modafinil
olanzapine
olanzapine-fluoxetine combination
quetiapine
risperidone
sertindole
valproate (divalproex)
ziprasidone
alprazolam (adjunct)
amoxapine
aripiprazole
asenapine
bupropion
carbamazepine
chlorpromazine
clonazepam (adjunct)
cyamemazine
doxepin
fluoxetine
flupenthixol
fluphenazine
gabapentin (adjunct)
haloperidol
iloperidone
lamotrigine
levetiracetam
lithium
lorazepam (adjunct)
loxapine
lurasidone
molindone
olanzapine
olanzapine-fluoxetine combination
oxcarbazepine
paliperidone
perphenazine
pipothiazine
quetiapine
risperidone
sertindole
thiothixene
topiramate (adjunct)
trifluoperazine
valproate (divalproex)
ziprasidone
zonisamide
zotepine
zuclopenthixol
Bipolar maintenance Depression
aripiprazole
asenapine
carbamazepine
iloperidone
lamotrigine
lithium
lurasidone
olanzapine
olanzapine-fluoxetine combination
quetiapine
risperidone (injectable)
sertindole
valproate (divalproex)
ziprasidone
agomelatine
amisulpride
amitriptyline
amoxapine
amphetamine (d)
amphetamine (d,l)
aripiprazole (adjunct)
asenapine
atomoxetine
bupropion
buspirone (adjunct)
citalopram
clomipramine
cyamemazine
desipramine
desvenlafaxine
dothiepin
doxepin
duloxetine
escitalopram
fluoxetine
flupenthixol
fluvoxamine
iloperidone
imipramine
isocarboxazid
ketamine
lisdexamfetamine
lithium (adjunct)
l-methylfolate (adjunct)
lofepramine
lurasidone
maprotiline
methylphenidate (d)
methylphenidate (d,l)
mianserin
milnacipran
mirtazapine
moclobemide
modafinil (adjunct)
nefazodone
nortriptyline
olanzapine
paroxetine
phenelzine
protriptyline
quetiapine (adjunct)
reboxetine
selegiline
sertindole
sertraline
sulpiride
tianeptine
tranylcypromine
triiodothyronine
trazodone
trimipramine
venlafaxine
vilazodone
vortioxetine

Note: Many of these medications are FDA approved for adults only. Some are FDA approved for disorders in children and adolescents. Many are used “off label” for the disorders examined in this week. As you read the Stahl drug monographs, focus your attention on FDA approvals for children/adolescents (including “ages” for which the medication is approved, if applicable) and further note which drugs are “off label.”

Optional Resources

Thapar, A., Pine, D. S., Leckman, J. F., Scott, S., Snowling, M. J., & Taylor, E. A. (2015). Rutter’s child and adolescent psychiatry (6th ed.). Hoboken, NJ: Wiley Blackwell.

  • Chapter 62, “Bipolar Disorder in Childhood” (pp. 858–873)
  • Chapter 63, “Depressive Disorders in Childhood and Adolescence” (pp. 874–892)

Discussion: Pediatric Bipolar Depression Disorder Debate

Some debate in the literature exists specific to whether or not bipolar disorder can be diagnosed in childhood. While some have anecdotally argued that it is not possible for children to develop bipolar disorder (as normal features of childhood confound the diagnosis), other sources argue that pediatric bipolar disorder is a fact.

In this Discussion, you engage in a debate as to whether pediatric bipolar disorder is possible to diagnose.

Learning Objectives

Students will:
  • Evaluate diagnosis of pediatric bipolar depression disorder
  • Analyze consequences to diagnosing/failing to diagnose pediatric bipolar depression disorder

To Prepare for the Discussion:

  • The instructor will assign you a position for or against the issue of diagnosing pediatric bipolar depression disorder.
  • Review the Learning Resources concerning the controversy over the diagnosis of pediatric bipolar depression disorder.

Note: For this Discussion, you are required to complete your initial post before you will be able to view and respond to your colleagues’ postings. Begin by clicking on the “Post to Discussion Question” link and then select “Create Thread” to complete your initial post. Remember, once you click submit, you cannot delete or edit your own posts and cannot post anonymously. Please check your post carefully before clicking Submit!

By Day 3

Post:

  • Write “for” or “against” in the subject line of your Discussion post.
  • Based on the position you were assigned, justify whether or not pediatric bipolar depression disorder should be diagnosed.

Support your position with evidence and examples.

By Day 6

Respond to at least two of your colleagues who argued the opposite side as you by countering their argument with evidence. Identify at least two consequences to support your position.

Submission and Grading Information

Grading Criteria

To access your rubric:

Week 8 Discussion Rubric

Post by Day 3 and Respond by Day 6

To participate in this Discussion:

Week 8 Discussion


Assignment: Board Vitals

This week you will be responding to twenty Board Vitals questions that cover a broad review of your Nurse Practitioner program courses up to this point.

These review questions will provide practice that is critical in your preparation for the national certification exam that’s required to certify you to practice as a nurse practitioner. These customized test questions are designed to help you prepare for your Nurse Practitioner certification exam. It is in your best interest to take your time, do your best, and answer each question to the best of your ability.

You can access Board Vitals through the link sent to you in email or by following the link below:

https://www.boardvitals.com/

By Day 7

Complete the Board Vitals questions.


Making Connections

This week, you debated the theory that bipolar depression can or cannot be diagnosed in children and adolescents.

Next week, you will compare evidence-based treatment plans for adults versus children diagnosed with schizophrenia. You analyze the legal and ethical issues involved with forcing clients with early-onset schizophrenia to take medications for the disorder. You also complete a Decision Tree concerning children with psychotic disorders.


Looking Ahead 1

In Week 9, you will work with our group again to create a new Parent Guide, focusing on feeding, eating, and elimination disorders in childhood.


Looking Ahead 2

You should be working on your cover letter, resume, and portfolio that is due in Week 10.

NURS 6660 Discussion: Pediatric Bipolar Depression Disorder Debate

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